From the Guidelines
For swimmers with tympanostomy tubes, the safest ear drops are those specifically labeled for use with ear tubes, such as Ciprodex (ciprofloxacin/dexamethasone) or Floxin Otic (ofloxacin), as recommended by the most recent clinical practice guideline 1. When considering ear drops for swimmers with ear tubes, it's essential to prioritize products that are safe and effective in preventing infection.
- Medicated ear drops like Ciprodex or Floxin Otic can be used before or after swimming to prevent infection.
- Non-medicated options like mineral oil drops or silicone-based drops, such as Ear Dry or SwimSeal, can create a water-resistant barrier without causing irritation.
- Acidic drops like vinegar solutions should be avoided as they can cause pain and irritation when they pass through the tubes into the middle ear. According to the latest guidelines, routine water precautions, such as using earplugs or headbands, are not recommended for children with tympanostomy tubes 1, 1. However, custom-fitted ear plugs or swim bands can provide additional protection during water activities. It's crucial to use products specifically designed to be safe if they pass through the ear tube opening, as ear tubes create an open passage between the outer ear and middle ear. The American Academy of Otolaryngology-Head and Neck Surgery recommends using antibiotic ear drops, such as ofloxacin or ciprofloxacin-dexamethasone, for up to 10 days to treat ear infections with visible drainage or discharge from the ear canal 1. When using any drops, it's essential to tilt the head to the side, place 3-5 drops in the ear canal, and remain in that position for 1-2 minutes to allow the drops to work.
From the FDA Drug Label
What activities should be avoided while using ofloxacin otic solution? It is important that the infected ear(s) remain clean and dry. When bathing, avoid getting the infected ear(s) wet. Avoid swimming unless the doctor has instructed otherwise.
The ear drops ofloxacin otic solution can be used for swimmers with ear tubes, but swimming should be avoided unless the doctor has instructed otherwise.
- The patient should follow the doctor's instructions for using the ear drops.
- It is essential to keep the infected ear clean and dry.
- If a dose is missed, it should be given as soon as possible, but do not use a double dose unless the doctor has instructed you to do so 2.
From the Research
Ear Drops for Swimmers with Tympanostomy Tubes
- The use of ear drops for swimmers with tympanostomy tubes is a topic of debate, with some studies suggesting that they may not be necessary to prevent ear infections 3, 4.
- One study found that the use of antibiotic ear drops after swimming did not significantly reduce the incidence of post-tympanostomy water-related otorrhea 3.
- Another study found that swimming without earplugs did not result in an increased incidence of middle ear infections in patients with tympanostomy tubes 5.
- A study that investigated the possibility of water penetration through ventilation tubes into the middle ear while swimming found that water penetration into the middle ear through ventilation tubes and middle ear infection are not likely when surface swimming 6.
Safe Ear Drops for Swimmers with Ear Tubes
- Polymyxin B sulfate, neomycin sulfate, and hydrocortisone (Pediotic) ear drops have been studied as a potential option for swimmers with tympanostomy tubes, but their effectiveness in preventing ear infections is unclear 3.
- There is limited evidence to support the use of specific ear drops for swimmers with tympanostomy tubes, and more research is needed to determine the safest and most effective options.
Precautions for Swimmers with Tympanostomy Tubes
- Some studies suggest that young children with tympanostomy tubes who surface swim and do not dive may not need to take water precautions, such as using earplugs or antibiotic ear drops 3, 4.
- However, it is still important for swimmers with tympanostomy tubes to take precautions to prevent ear infections, such as avoiding diving and swimming in dirty or contaminated water 6, 3.